Layer arrangements for surgical staple cartridges

ABSTRACT

A piece of buttress material and an end-effector of a surgical instrument including features which can aid a surgeon in properly and quickly attaching the piece of buttress material to the end-effector. In various embodiments, a piece of buttress material can include retention features which can be engaged with portions of an end-effector to releasably retain the piece of buttress material to at least a portion of the end-effector. Similarly, an end-effector can include features configured to engage portions of a piece of buttress material to releasably retain the piece of buttress material to the end-effector. In at least one embodiment, more than one piece of buttress material can be releasably retained to an end-effector.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation application claiming priority under35 U.S.C. §120 to U.S. patent application Ser. No. 13/763,095, entitledLAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES, filed Feb. 8, 2013,now U.S. Patent Application Publication No. 2013/0161374, which is acontinuation-in-part application claiming priority under 35 U.S.C. §120to U.S. patent application Ser. No. 12/032,002, entitled SURGICAL ENDEFFECTOR HAVING BUTTRESS RETENTION FEATURES, filed Feb. 15, 2008, whichissued on Feb. 12, 2013 as U.S. Pat. No. 8,371,491, the entiredisclosures of which are hereby incorporated by reference herein.

BACKGROUND

i. Field of the Invention

The present invention generally relates to buttress material for asurgical instrument, and to buttress material configured to bereleasably attached to an end-effector assembly of a surgicalinstrument.

ii. Description of the Related Art

A surgical instrument, such as a surgical stapler, for example, can beconfigured to deploy staples into tissue during a surgical procedure. Invarious embodiments, the surgical stapler can include an end-effectorconfigured to be positioned on a distal end of the surgical stapler. Theend-effector can be configured to be positioned within, and slid atleast partially through, a cannula, or trocar, positioned in a wall of apatient's body such that a surgeon can utilize the end-effector toperform work within a surgical site. In various embodiments, theend-effector can comprise a first jaw member including a staplecartridge and, additionally, a second jaw member including an anvil. Thefirst and second jaw members can be configured to be moved proximallytowards each other to clamp layers of tissue therebetween and apply acompressive force thereto. In at least one embodiment, the staplecartridge can be configured to removably store staples therein and theanvil can be configured to deform the staples as they are deployed fromthe staple cartridge.

In some circumstances, the layers of tissue can be relatively thin, canhave a high fluid content, and/or can have a non-uniform thickness,which can cause the staples to be improperly formed within the tissue.To ameliorate this problem, a piece of buttress material can be utilizedto support the tissue as the tissue is being clamped and stapled. In atleast one embodiment, a piece of buttress material can be releasablyattached to at least one of the first and second jaw members before theyare inserted into a surgical site. In various embodiments, the piece ofbuttress material can be utilized to distribute the compressive forceapplied by the anvil over the surface area of the buttress material inorder to create a more uniform tissue compression profile within thetissue. In at least one embodiment, a uniform tissue compression profilecan increase the likelihood that that the staples will be properlyformed in the tissue.

In various embodiments, a piece of buttress material can be difficultfor a surgeon to attach to the jaw members of an end-effector. In atleast one embodiment, the piece of buttress material can be attached toone of the jaw members using an adhesive configured to releasably retainthe piece of buttress material thereto. In such an embodiment, a surgeonmust carefully align the piece of buttress material with the jaw memberowing to the possibility that the adhesive may immediately bond thebuttress material to the jaw member. In such circumstances, the piece ofbuttress material may have to be removed from the jaw member andreplaced a new piece of buttress material. As a result, the surgeon canspend valuable time positioning and aligning a piece of buttressmaterial on a jaw member of an end-effector. What is needed is animprovement over the foregoing.

SUMMARY

In at least one form of the invention, a piece of buttress materialand/or an end-effector of a surgical instrument can include featureswhich can aid a surgeon, or other clinician, in properly aligning andattaching a piece of buttress material to an end-effector. In at leastone embodiment, the piece of buttress material can include at least onemember extending therefrom, wherein the member can be configured to beengaged with one of a staple cavity defined in a staple cartridge and/oran anvil pocket defined in an anvil. In at least one such embodiment,the member can be friction-fit and/or press-fit within the staple cavityand/or the anvil pocket to releasably retain the piece of buttressmaterial to one of the staple cartridge and the anvil, for example. Invarious embodiments, a notch or slot can be defined in one of a staplecartridge and/or an anvil wherein the notch can be configured to receivea portion of a piece of buttress material and releasably retain thepiece of buttress material thereto. In at least one embodiment, a pieceof buttress material can include a projection extending therefrom,wherein the projection can be configured to be releasably engaged with acutting member channel in at least one of the staple cartridge and theanvil. In such an embodiment, the projection can be press-fit,friction-fit, and/or otherwise engaged with the channel, for example.

In at least one form of the invention, a piece of buttress material andan end-effector can include co-operating features, such as lips, forexample, which can allow the piece of buttress material to be attachedto the end-effector in a snap-fit fashion. In various embodiments, anend-effector can include resilient members extending therefrom, whereinthe resilient members can be configured to contact portions of the pieceof buttress material and releasably retain the buttress material to theend-effector. In at least one embodiment, one of the staple cartridgeand the anvil can include a plurality of retaining members whereinportions of a piece of buttress material can be friction-fit against theretaining members to releasably retain the piece of buttress material tothe staple cartridge and/or anvil.

In at least one form of the invention, a piece of buttress material canbe releasably attached to a sleeve, wherein the sleeve can be configuredto be slid over at least one of the staple cartridge and the anvil of anend-effector. In at least one embodiment, the piece of buttress materialcan include a side portion which can be attached to the sleeve and, inaddition, a body portion configured to be engaged with staples when thestaples are deployed from the staple cartridge. In such an embodiment,the side portion can be used to releasably retain the body portion tothe sleeve. In at least one embodiment, a recess and/or perforation canbe defined in the piece of buttress material intermediate the sideportion and the body portion, for example, such that the body portioncan be separated from the side portion. In at least one embodiment, as aresult, the perforation and/or recess can allow the sleeve to be removedfrom the buttress material after the staples have been deployed into thebody portion.

In at least one form of the invention, a package for a piece of buttressmaterial can be utilized to quickly align and position a piece ofbuttress material within an end-effector. In various embodiments, apackage can include a first portion, a second portion, and a piece ofbuttress material which can be releasably attached to the first portion.In at least one embodiment, the second portion can be configured to bemoved between a first position in which it is adjacent to the piece ofbuttress material and a second position. In various embodiments, thepiece of buttress material can be exposed when the second portion is inthe second position such that the package can be positioned intermediatejaw members of an open end-effector to engage the exposed piece ofbuttress material to one of the jaw members of the end-effector. Invarious embodiments, the buttress material can include an adhesivethereon for retaining the buttress material to one of the maw members.After the piece of buttress material is engaged with one of the jawmembers, the second portion can be pulled away from the end-effector torelease the first portion from the piece of the buttress material.

In at least one form of the invention, a piece of buttress material canbe fastened to at least one of an anvil and a staple cartridge of anend-effector. In various embodiments, an anvil and/or staple cartridgecan include one or more apertures, or openings, therein which can beconfigured to receive one or more fasteners to retain a piece ofbuttress material to the anvil or staple cartridge. In variousembodiments, the fasteners can be released from the apertures in theanvil and/or staple cartridge to allow the piece of buttress material toseparate from the end-effector. The fasteners can also be configured todetach from the piece of buttress material and can be comprised of abioabsorbable material such that they can be resorbed within thepatient's body. In at least one embodiment, a piece of buttress materialcan be attached to an end effector by one or more detachable clips.

In at least one form of the invention, a piece of buttress materialconfigured to be releasably attached to an end-effector can include anunactivated adhesive. In various embodiments, a surgeon can position andalign the piece of buttress material on the end-effector multiple timeswithout the un-activated adhesive bonding to the end-effector. Once thesurgeon is satisfied with the alignment of the piece of buttressmaterial on the end-effector, the surgeon can then apply a reactant tothe un-activated adhesive. In various embodiments, the reactant canactivate the adhesive and cause the adhesive to releasably bond thepiece of buttress material to a portion of the end-effector. In at leastone embodiment, the piece of buttress material can include a recessconfigured to receive an applicator such that the application of thereactant to the un-activated adhesive can be facilitated.

In at least one form of the invention, an end effector can include aretractable retention member for retaining a piece of buttress materialon an end-effector. In various embodiments, the retention member can bemovable between a first, or distal, position and a second, or proximal,position. In at least one embodiment, the flexible member can beoperably engaged with a handle portion such that a surgeon can utilizethe handle portion to retract the flexible member relative to theend-effector. In various embodiments, the flexible member can hold thepiece of buttress material in position while staples are deployedthrough the buttress material. In at least one embodiment, the retentionmember can be retracted relative to the end effector such that thebuttress material can be disengaged from the end effector and the endeffector can be removed from the surgical site.

BRIEF DESCRIPTION OF THE DRAWINGS

The above-mentioned and other features and advantages of this invention,and the manner of attaining them, will become more apparent and theinvention itself will be better understood by reference to the followingdescription of embodiments of the invention taken in conjunction withthe accompanying drawings, wherein:

FIG. 1 is a perspective view of an end-effector assembly configured toengage, cut, staple, and apply a piece of buttress material to tissue inaccordance with one non-limiting embodiment of the present invention;

FIG. 2 is a perspective view of the end-effector assembly of FIG. 1after the end-effector has been utilized to engage, cut, staple, andapply the piece of buttress material to the tissue in accordance withone non-limiting embodiment of the present invention;

FIG. 3 is a perspective view of an end-effector assembly attached to adistal end of a surgical instrument in accordance with one non-limitingembodiment of the present invention;

FIG. 4 is a perspective view of an end-effector assembly including atleast one piece of buttress material, wherein the end-effector assemblyis in an open configuration in accordance with one non-limitingembodiment of the present invention;

FIG. 5 is a perspective view of a staple cartridge of the end-effectorassembly of FIG. 4, wherein the buttress material is releasably retainedthereto;

FIG. 6 is an exploded perspective view of the staple cartridge and thebuttress material of FIG. 5;

FIG. 7 is a perspective view of a connection member configured to beused with the end-effector assembly of FIG. 4;

FIG. 8 is a perspective view of an anvil of the end-effector assembly ofFIG. 4, wherein the anvil has at least one piece of buttress materialreleasably retained thereto;

FIG. 9 is a side view of the connection member of FIG. 7;

FIG. 10 is an exploded perspective view of the anvil and the buttressmaterial of FIG. 8;

FIG. 11 is a perspective view of a staple cartridge and an anvil of anend-effector assembly with pieces of buttress material attached theretoin accordance with one non-limiting embodiment of the present invention;

FIG. 12 is an exploded view of an end-effector assembly including astaple cartridge and an anvil in accordance with one non-limitingembodiment of the present invention;

FIG. 13 is an exploded view of the end-effector assembly of FIG. 12 withsome components removed;

FIG. 14 is a front view of the end-effector assembly of FIG. 12;

FIG. 15 is a perspective view of an end-effector assembly in accordancewith another non-limiting embodiment of the present invention;

FIG. 16 is a partial perspective view of the end-effector assembly ofFIG. 15 with some components removed, wherein the end-effector assemblyincludes a retractable member configured to releasably retain at leastone piece of buttress material;

FIG. 17 is an end view of the end-effector assembly of FIG. 15 takenalong line 17-17 in FIG. 16;

FIG. 18 is an exploded partial perspective view of the end-effectorassembly of FIG. 15;

FIGS. 19-21 are side views of various cutting members configured to beused with an end-effector assembly in accordance with non-limitingembodiments of the present invention;

FIG. 22 is a perspective view of a staple cartridge having a piece ofbuttress material releasably retained thereto in accordance with onenon-limiting embodiment of the present invention;

FIG. 23 is an exploded perspective view of the staple cartridge and thepiece of buttress material of FIG. 22, wherein the piece of buttressmaterial includes a plurality of members extending therefrom;

FIG. 24 is a cross-sectional view taken along line 24-24 in FIG. 22illustrating the members of FIG. 23 engaged with staple cavities inaccordance with one non-limiting embodiment of the present invention;

FIG. 25 is a cross-sectional view of a piece of buttress materialincluding members engaged with staple cavities of a staple cartridge inaccordance with one non-limiting embodiment of the present invention;

FIG. 26 is an exploded view of FIG. 25 illustrating the membersseparated from the staple cavities of the staple cartridge in accordancewith one non-limiting embodiment of the present invention;

FIG. 27 is an exploded cross-sectional view of an end-effector assemblyincluding retaining members extending from an anvil and a staplecartridge of the end-effector which are configured to releasably retaina piece of buttress material in accordance with one non-limitingembodiment of the present invention;

FIG. 28 is an exploded cross-sectional view of an end-effector assemblyincluding retaining members extending from an anvil and a staplecartridge of the end-effector which are configured to releasably retaina piece of buttress material in accordance with one non-limitingembodiment of the present invention;

FIG. 29 is a cross-sectional view of an end-effector illustrating apiece of buttress material positioned within the end-effector, whereinthe piece of buttress material includes recesses in accordance with onenon-limiting embodiment of the present invention;

FIG. 30 is a cross-sectional view of an end-effector illustrating apiece of buttress material positioned within the end-effector, whereinthe piece of buttress material includes perforations and recesses inaccordance with one non-limiting embodiment of the present invention;

FIG. 31 is a perspective view of portions of the piece of buttressmaterial of FIG. 30 being removed from an intermediate portion;

FIG. 32 is a cross-sectional view of an anvil having a piece of buttressmaterial engaged with a cutting member slot in accordance with onenon-limiting embodiment of the present invention;

FIG. 33 is a cross-section view of a staple cartridge including a pieceof buttress material releasably retained thereto in accordance with onenon-limiting embodiment of the present invention;

FIG. 34 is a cross-sectional view of a piece of buttress materialreleasably positioned on an anvil in accordance with one non-limitingembodiment of the present invention;

FIG. 35 is a detail view of a piece of buttress material releasablyretained to an anvil in accordance with one non-limiting embodiment ofthe present invention;

FIG. 36 is a detail view of a piece of buttress material releasablyretained to an anvil in accordance with one non-limiting embodiment ofthe present invention;

FIG. 37 is a detail view of a piece of buttress material releasablyretained to an anvil in accordance with one non-limiting embodiment ofthe present invention;

FIG. 38 is a perspective view of a package assembly including a piece ofbuttress material, wherein the package assembly is positioned within anopen end-effector of a surgical instrument in accordance with onenon-limiting embodiment of the present invention;

FIG. 39 is a perspective view of the package assembly of FIG. 38illustrating the end-effector closed onto the package and the piece ofbuttress material;

FIG. 40 is a perspective view of the package of FIG. 39 illustrating thepiece of buttress material engaged with an anvil of the end-effector andthe package being removed from the piece of buttress material inaccordance with one non-limiting embodiment of the present invention;

FIG. 41 is a perspective view of a package assembly for a piece ofbuttress material in a sterile outer package in accordance with onenon-limiting embodiment of the present invention;

FIG. 42 is a perspective view of an inner package of the packageassembly of FIG. 41 in an unopened position;

FIG. 43 is a perspective view of the package of FIG. 42 in a partiallyopened position;

FIG. 44 is a perspective view of the package of FIG. 42 in an openedposition;

FIG. 45 is a perspective view of the package of FIG. 42 positionedwithin an open end-effector;

FIG. 46 is a perspective view of the package of FIG. 45 wherein thepackage is partially removed from the end-effector;

FIG. 47 is a perspective view of an applicator assembly for a piece ofbuttress material, wherein the applicator assembly is positioned withinan end-effector of a surgical instrument in accordance with onenon-limiting embodiment of the present invention;

FIG. 48 is a top view of the applicator assembly of FIG. 47;

FIG. 49 is a top view of an applicator assembly in accordance with onealternative non-limiting embodiment of the present invention;

FIG. 50 is a perspective view of a buttress material applicator assemblyin accordance with one non-limiting embodiment of the present invention;

FIG. 51 is another perspective view of the buttress material applicatorassembly of FIG. 50;

FIG. 52 is a perspective view of the buttress material applicatorassembly of FIG. 50 positioned within an end-effector of a surgicalinstrument;

FIG. 53 is a perspective view of the buttress material applicatorassembly of FIG. 50 partially removed from the end-effector;

FIG. 54 is a perspective view of a buttress material applicatorconfigured to apply at least one piece of buttress material to anend-effector of a surgical instrument in accordance with onenon-limiting embodiment of the present invention;

FIG. 55 is an exploded view of the buttress material applicator of FIG.54;

FIG. 56 is an elevational view of the buttress material applicator ofFIG. 54 with some components removed;

FIG. 57 is a perspective view of the buttress material applicator ofFIG. 54 with some components removed;

FIG. 58 is a perspective view of an alternative buttress materialapplicator configured to apply at least one piece of buttress materialto an end-effector of a surgical instrument in accordance with anothernon-limiting embodiment of the present invention;

FIG. 59 is an exploded perspective view of the buttress materialapplicator of FIG. 58;

FIG. 60 is an elevational view of the buttress material applicator ofFIG. 58 with some components removed;

FIG. 61 is a perspective view of the buttress material applicator ofFIG. 58 with some components removed;

FIG. 62 is a perspective view of a piece of buttress material inaccordance with one non-limiting embodiment of the present invention;and

FIG. 63 is a cross-sectional view of the piece of buttress material ofFIG. 62 taken along line 63-63 in FIG. 62.

DETAILED DESCRIPTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those of ordinary skill in the art will understand that thedevices and methods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the various embodiments of the present invention is definedsolely by the claims. The features illustrated or described inconnection with one exemplary embodiment may be combined with thefeatures of other embodiments. Such modifications and variations areintended to be included within the scope of the present invention.

In various embodiments, referring to FIGS. 1-2, an end-effector of asurgical instrument can include at least one piece of buttress material“B” releasably attached thereto. In at least one embodiment, theend-effector can be configured to engage and clamp tissue “T”, deploystaples into the tissue, and cut the tissue and the piece of buttressmaterial. In such an embodiment, the end-effector can then be removedfrom the tissue leaving the staples and the piece of buttress materialattached to the tissue on either side of an incision “I”. In variousembodiments, a surgical instrument can include a handle assembly, anend-effector assembly, an instrument shaft, and at least one piece ofbuttress material releasably attached to the end-effector assembly. Inat least one embodiment, referring to FIG. 3, handle assembly 12 can beattached to a first, or proximal, end 13 of instrument shaft 16 and,additionally, end-effector assembly 14 can be configured to be attachedto a second, or distal, end 15 of instrument shaft 16. In variousembodiments, end-effector assembly 14 and at least a portion ofinstrument shaft 16 can be configured to be positioned within, andinserted at least partially through, a cannula, or trocar, in apatient's body during a minimally invasive surgical procedure. Varioussurgical instruments are described in further detail in U.S. patentapplication Ser. No. 11/329,020, entitled SURGICAL INSTRUMENT HAVING ANARTICULATING END EFFECTOR, which was filed on Jan. 10, 2006, now U.S.Pat. No. 7,670,334; U.S. patent application Ser. No. 11/343,321,entitled SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGERLOCKING MECHANISM, which was filed on Jan. 31, 2006, now U.S. PatentApplication Publication No. 2007/0175955; and U.S. patent applicationSer. No. 11/529,935, entitled SURGICAL STAPLES HAVING ATTACHED DRIVERSAND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME, which was filed on Sep.29, 2006, now U.S. Pat. No. 8,485,412, the entire disclosures of whichare hereby incorporated by reference herein.

In various embodiments, an end-effector assembly of a surgicalinstrument can include a first jaw member and a second jaw memberwherein at least one of the first and second jaw members can beconfigured to be moved relative to the other jaw member such that tissuecan be clamped therebetween. In various embodiments, referring to FIGS.4-11, first jaw member 20 can include staple cartridge 22 and,additionally, second jaw member 24 can include anvil 26. In at least oneembodiment, staple cartridge 22 can include deck 28 having a pluralityof staple cavities 30 defined therein. Anvil 26 can include anvil cover27 and anvil face 32, wherein anvil face 32 can have a plurality ofanvil pockets 34 defined therein. In various embodiments, each staplecavity 30 can be configured to removably store a staple therein and eachanvil pocket 34 can be configured to deform at least a portion of thestaple as the staple is deployed. In various embodiments, at least oneof the staple cartridge and the anvil can comprise one or more grippingfeatures, or ridges, 35 which can be configured to hold the tissuewithin the end effector.

Further to the above, referring to FIGS. 4-11, end-effector assembly 14can include at least one piece of buttress material 36 and/or 36′ whichcan be configured to be positioned intermediate the first and second jawmembers and can be releasably retained to one of deck 28 and/or face 32,for example. In at least one embodiment, a surface on the piece ofbuttress material can be configured to contact tissue as the tissue isclamped between the first and second jaw members. In such an embodiment,the buttress material surface can be used to distribute the compressiveclamping force over the tissue, remove excess fluid from the tissue,and/or improve the purchase of the staples. In various embodiments, oneor more pieces of buttress material can be positioned within theend-effector assembly. In at least one embodiment, referring to FIG. 11,one piece of buttress material 36 a can be attached to staple cartridge22 and one piece of buttress material 36 a′ can be attached to anvil 24.In at least one other embodiment, two pieces of buttress material 36 canbe positioned on deck 28 and one piece of buttress material 36′ can bepositioned on face 32, for example. In other various embodiments, anysuitable number of pieces of buttress material can be situated within anend-effector assembly. In any event, in various embodiments, thepiece(s) of buttress material can be comprised of a material such as, abioabsorbable material, a biofragmentable material, and/or a dissolvablematerial, for example, such that the buttress material can be absorbed,fragmented, and/or dissolved during the healing process. In at least oneembodiment, the piece(s) of buttress material can be at least partiallycomprised of a therapeutic drug which can be configured to be releasedover time to aid the tissue in healing, for example. In further variousembodiments, the piece(s) of buttress material can include anon-absorbable and/or non-dissolvable material, for example.

In various embodiments, referring to FIGS. 6, 7, 9, and 10, anend-effector assembly can include at least one connection member orfastener which can be utilized to releasably retain a piece of buttressmaterial to at least one of an anvil and a staple cartridge, forexample. In at least one embodiment, each connection member, such asconnection member 38, for example, can include body 40, wherein body 40can be cylindrically-shaped, for example. In at least one suchembodiment, connection member 38 can also include an outwardly flaredhead portion 42 configured to prevent, or at least inhibit, theconnection member from sliding through an aperture or opening 44 in thepiece of buttress material. In other various embodiments, a connectionmember can include any other suitably shaped configuration to retain apiece of buttress material to an end effector. In at least oneembodiment, one ore more connection members can comprise a clasp whichcan be configured to detachably retain the buttress material to a staplecartridge and/or anvil.

In various embodiments, referring to FIGS. 7 and 9, head portion 42 caninclude recess 43, wherein recess 43 can be configured to receive adriver, a press, or any other suitable device. In at least oneembodiment, the driver or press can be engaged with recess 43 andutilized to insert connection members 38 through the piece of buttressmaterial and into engagement with one of staple cartridge deck 28 andanvil face 32, for example. In at least one such embodiment, deck 28and/or face 32 can include apertures 46 which can be configured toreceive at least a portion of the connection members, such as body 40,for example. In various embodiments, the outer perimeter of body 40 andthe inner perimeter of an aperture 46 can cooperate to retain connectionmembers 38 to one of the anvil and the staple cartridge in afriction-fit or press-fit manner. Further to the above, referring toFIGS. 6 and 10, a piece of buttress material can include pre-formedapertures 44 which can be configured to allow connection members 38 topass therethrough into apertures 46, for example. In at least oneembodiment, piece of buttress material 36 can be positioned adjacent to,or against, one of deck 28 and face 32 such that buttress apertures 44can be axially aligned with apertures 46. In such circumstances,connection members 38 can then be positioned through buttress apertures44 and into apertures 46 to releasably retain the piece of buttressmaterial to one of deck 28 and face 32.

Further to the above, a connection member can include threads which canbe threadably engaged with an aperture in a staple cartridge and/oranvil, for example. In various embodiments, such threads can includeself-tapping threads and/or they can be configured to threadably engagethreads within the aperture. In embodiments which utilize self-tappingconnection members, the connection members can be used in conjunctionwith a piece of buttress material, a staple cartridge, and/or anvilwhich do not have pre-formed or pre-bored apertures defined therein. Ineither event, the purchase between the connection members and the anvilor staple cartridge apertures may be sufficient to hold the buttressmaterial in place, yet allow the buttress material to strip away fromthe staple cartridge and/or deck when appropriate. In at least oneembodiment, outwardly flared head portion 42 can be configured to becountersunk into a bevel surrounding an aperture 46 in order to providea smooth, or at least substantially smooth, tissue-contacting surface onthe piece of buttress material and reduce the possibility that tissuemay be caught or snagged on a connection member.

In various embodiments, connection members can be configured to bereleased from an end effector and deployed along with a piece ofbuttress material. In at least one embodiment, head portions of theconnection members can be configured to be separated from body portionsof the connection members such that the head portions can be deployedwith the piece of buttress material while the body portions remainattached to the end effector. In other various embodiments, the entiretyof the connection members can remain engaged with the end effector whenthe piece of buttress material is detached from the end-effector. In anyevent, in at least one embodiment, the connection members can be atleast partially comprised of at least one of a bioabsorbable material, abiofragmentable material, and a dissolvable material such that theconnection members can be absorbed, fragmented, and/or dissolved withinthe body. In various embodiments, the connection members comprised of atherapeutic drug which can be configured to be released over time to aidthe tissue in healing, for example. In further various embodiments, theconnection members can include a non-absorbable and/or non-dissolvablematerial, for example, such as a plastic.

In various embodiments, the connection members can be arranged in anysuitable pattern or configuration. In at least one embodiment, theconnection members can be situated around the outer perimeter of pieceof buttress material 36, for example. In at least one embodiment, theconnection members can be positioned proximate to one or more sidesand/or ends of the piece of buttress material, for example, to prevent,or at least assist in preventing, the buttress material from peelingaway from the staple cartridge deck and/or the anvil face when theend-effector is inserted through a trocar or engaged with tissue. Invarious embodiments, the connection members can be used in conjunctionwith any suitable adhesive, such as cyanoacrilate, for example, toreleasably retain the piece of buttress material, or at least a portionof the buttress material, to the end effector. In at least oneembodiment, the adhesive can be applied to connection members prior tothe connection members being engaged with the apertures in the piece ofbuttress material, staple cartridge, and/or anvil.

In various embodiments, referring to FIGS. 12-14, at least one resilientmember can be utilized to releasably retain a piece of buttress materialto a staple cartridge and/or anvil of an end effector. In at least oneembodiment, at least one resilient member, such as resilient members 150or 150′, for example, can include a first end, such as first ends 152 or152′, configured to be attached to, or integrally formed with, at leastone of first and second jaw members 120 and 124. In at least oneembodiment, each resilient member 150 can include a second end, such assecond ends 154 or 154′, for example, configured to contact andreleasably retain a piece of buttress material, such as piece ofbuttress material 136 or 136′, to at least one of the first and secondjaw members. In various embodiments, second end 154 can include tip 158which can be configured to grip at least a portion of piece of buttressmaterial 136, for example. In various embodiments, tip 158 can becontoured and/or configured to include a rough or ribbed surface, forexample, in order to frictionally engage the piece of buttress material.

In various embodiments, referring again to FIGS. 12-14, a plurality ofresilient members can be provided on at least two sides of a jaw memberto retain side portions of the piece of buttress material to the jawmember. In at least one embodiment, first ends 152 of each individualresilient member 150 can be attached to one another by a connectingmember, such as connecting member, or bar, 156 or 156′, for example. Invarious embodiments, connecting member 156 can be attached to second jawmember 124 such that connection member 156 can provide support toresilient members 150. In other various embodiments, a plurality ofresilient members 150 can be attached to at least one of the first andsecond jaw members without the use of a connecting member. In such anembodiment, the first ends of the resilient members can be attacheddirectly to one of the first and second jaw members, for example.

Further to the above, in various embodiments, at least one resilientmember can be biased towards the piece of buttress material such thatthe resilient members can apply a retaining force to the piece ofbuttress material and releasably retain the piece of buttress materialto one of the first and second jaw members. In at least one embodiment,the piece of buttress material can include tissue-contacting portion 159or 159′ and two side portions 160 or 160′ extending in a substantiallyperpendicular and/or transverse direction with respect totissue-contacting portion 159 or 159′. In at least one such embodiment,tissue contacting portion 159 can be configured to be positionedadjacent to or in contact with deck 128 and, in addition, side portions160 can be configured to abut side walls 121 of first jaw member 120.Similarly, tissue contacting portion 159′ can be positioned adjacent toor in contact with surface 132 and, in addition, side portions 160′ canbe configured to abut side walls 125 of second jaw member 124. Invarious embodiments, each second end 154 of each resilient member 150can be configured to engage the side portions 160 of piece of buttressmaterial 136 and apply a retaining force thereto. In at least oneembodiment, resilient members 150, for example, can be configured torelease buttress material 136 after staples have been deployed throughthe buttress material and/or when the buttress material is disengagedfrom the end-effector. In at least one embodiment, the resilient memberscan be comprised of an elastic material such as metal or plastic, forexample.

In various embodiments, referring to FIGS. 15-18, a retention member canbe configured to be moved within an end-effector between a firstposition and a second position to releasably retain a piece of buttressmaterial to the end-effector. In at least one embodiment, end-effectorassembly 214 can include a first jaw including staple cartridge 222 anda second jaw including anvil 226 wherein retention member 262 can bemoved relative to staple cartridge 222 and anvil 226. In variousembodiments, retention member 262 can be moved between a first, orextended, position near distal end 264 to a second, or retracted,position near proximal end 263. In its extend position, retention member262 can hold buttress material 236 in position as end effector 214 isinserted into a surgical site. Thereafter, end effector 214 can beclosed onto tissue, for example, and staples can be deployed through thebuttress material into the tissue. In various embodiments, retentionmember 262 can be moved into its retracted position such that retentionmember 262 can be operably disengaged from buttress material 236. In atleast one embodiment, retention member 262 can be retracted prior to thestaples being deployed. In any event, as a result of the above, endeffector 214 can be opened and withdrawn from the surgical site leavingbehind the stapled buttress material and tissue.

In various embodiments, a retention member can have proximal ends whichcan be operably engaged with a lever or other actuating mechanism in ahandle portion of a surgical stapling instrument such that a surgeon canremotely retract the retention member as outlined above. In at least oneembodiment, retention member 262 can have distal ends which can beengaged with, or otherwise releasably retained by, retention bar 264such that a force may need to be applied to retention members 262 todislodge them from retention bar 264. Thereafter, retention members 262can be retracted proximally a distance L in order to move them intotheir second position. In at least one embodiment, retention members 262can be retracted through channels or apertures 266 in buttress material236, for example, until they are sufficiently removed from the buttressmaterial. In at least one such embodiment, apertures 266 can encircleand guide retention members 262 as they are retracted. In variousembodiments, the retention members can be comprised of flexible wires.In at least one embodiment, an end effector can include two or morepieces of buttress material retained to an end effector by retractableretention members. In at least one such embodiment, referring to FIGS.17 and 18, end effector 214 can include retention members 262′ forholding buttress material 236′ in position.

In various embodiments, an end-effector assembly can include a cuttingmember configured to incise one or more pieces of buttress material. Inat least one embodiment, a cutting member can be motivated relative toan end-effector by a surgical instrument firing drive and can be guidedby a cutting member slot within an anvil and/or staple cartridge of anend-effector. In at least one embodiment, referring to FIG. 19, topportion 267 of cutting member 268 can be configured to slide within aslot in the anvil and, additionally, bottom portion 269 of the cuttingmember can be configured to slide within a slot within the staplecartridge. In various embodiments, cutting member 268 can include blade270 having a positive slope, i.e., a cutting edge having a bottom endwhich is positioned distally with respect to a top end. In at least oneembodiment, such a configuration can be configured to incise thebuttress material without substantially pushing the buttress materialdistally and disrupting the alignment of the buttress material withinthe end-effector. In at least one alternative embodiment, referring toFIG. 20, blade 270′ of cutting member 268′ can include a negative slope,i.e., a cutting edge having a bottom end which is positioned proximallywith respect to a top end. In further alternative embodiments, referringto FIG. 21, blade 270″ of cutting member 268″ can include first portion270 a″ having a positive slope and second portion 270 b″ having anegative slope.

As outlined above, an end-effector assembly can include a staplecartridge, an anvil, and at least one piece of buttress materialpositioned intermediate the staple cartridge and the anvil. In at leastone embodiment, referring to FIGS. 22-24, a piece of buttress material,such as buttress material 336, can be configured to be snap-fit to atleast one of staple cartridge 322 and/or an anvil (not illustrated) toreleasably retain the piece of buttress material within the endeffector. Referring to FIGS. 23 and 24, staple cartridge 322 can includefirst side wall 302 and second side wall 304, wherein at least one ofthe first and second side walls can include a lip 306 extendingoutwardly therefrom. In various embodiments, buttress material 336 caninclude first edge, or side, 308, second edge, or side, 310, and atleast one lip 312 extending at least partially along the length of edges308 and 310. In at least one embodiment, referring to FIG. 24, lips 312can be configured to engage lips 306 in a snap-fit fashion in order toreleasably retain buttress material 336 to staple cartridge 322.

Further to the above, referring to FIG. 24, buttress material 336 caninclude surface 316 which can be configured to be positioned adjacent toor against deck 328 of staple cartridge 322. In at least one embodiment,side edges 308 and 310 can comprise sidewalls which can extend in aperpendicular or transverse direction relative to surface 316. In suchembodiments, lips 312 can extend from these sidewalls such that lips 312can be interlocked behind lips 306 of staple cartridge 322. In variousembodiments, lips 312 of buttress material 336 can be disengaged fromlips 306 of staple cartridge 322 when the staples are deployed fromstaple cartridge 322. More particularly, when the staples are deployed,the staples can contact buttress material 336, apply an upward force tobuttress material 336, and dislodge buttress material 336 from staplecartridge 322. Advantageously, as a result, buttress material 336 may beautomatically disengaged from staple cartridge 322 when the staples aredeployed therefrom and/or when the end-effector is opened as describedabove.

In various embodiments, referring to FIGS. 23 and 24, a piece ofbuttress material can include at least one member extending therefromwhich can be configured to releasably retain the buttress material toone of a staple cartridge and/or an anvil. In at least one embodiment,member 318 can extend from buttress material 336 in a direction which isperpendicular or transverse to surface 316. In various embodiments,member 318 can be engaged with one of staple cavity 320, and/or an anvilpocket, in a friction-fit or press-fit manner to releasably retain thepiece of buttress material to one of the staple cartridge and the anvil.Similar to the above, in various embodiments, staples deployed fromstaple cavities 320 can apply an upward force to buttress material 336and disengage members 318 from staple cavities 320. In variousembodiments, the staples can pierce projections 318 and/or buttressmaterial 336 to secure the buttress material to the tissue as outlinedabove.

As illustrated in FIG. 23, a piece of buttress material can include morethan one member, or projection, extending therefrom to retain a piece ofbuttress material to one of a staple cartridge and an anvil. In variousembodiments, referring to FIGS. 25-26, more than one member 318′ canextend from piece of buttress material 336′, for example. In at leastone embodiment, members 318′ can be can press-fit into staple cavities320′ of staple cartridge 322′, and/or into anvil pockets of an anvil(not illustrated), such that the members can frictionally retain thepiece of buttress material to the staple cartridge and/or the anvil asoutlined above. As described in greater detail below, a staple cartridgeand/or anvil can include slots or apertures therein in addition to thestaple cavities of the staple cartridge and the anvil pockets of theanvil for receiving projections, or retaining members, extending from apiece of buttress material.

In various embodiments, referring to FIG. 33, at least one of an anviland a staple cartridge of an end-effector assembly can include one ormore slots and/or grooves configured to releasably retain a piece ofbuttress material to the end-effector assembly. In at least oneembodiment, staple cartridge 722 can include at least one aperture 704defined therein which can be configured to receive projection 706extending from buttress material 736. In at least one such embodiment,projection 706 can be received within aperture 704 in a press-fit and/orfriction-fit fashion to releasably retain buttress material 736 thereto.In at least one embodiment, referring to FIG. 33, buttress material 736can include body 708 having surface 710, wherein surface 710 can beconfigured to be positioned adjacent to and/or abut deck 728. In variousembodiments, projection 706 can extend from body 708 in a directionwhich is perpendicular or transverse to a plane defined by surface 710,for example.

In various embodiments, projection 706, for example, can include firstportion, or leg, 712 and second portion, or foot, 714, wherein firstportion 712 can be configured to extend through aperture 704 and whereinsecond portion 714 can have a size and shape which can be slightlylarger than aperture 704, for example. In at least one such embodiment,projection 706 can be inserted into and pushed through aperture 704until second portion 714 at least partially extends therethrough. Invarious embodiments, projection 706 can deflect inwardly as it isinserted into aperture 704 and then snap outwardly after it has beeninserted therethrough. In addition to or in lieu of the above, secondportion 714 can be compressed as it is inserted into aperture 704 andthen expand once it has been inserted therethrough. In any event, secondportion 714 can engage a backside surface of deck 728 near aperture 704in order to releasably retain buttress material 736 to staple cartridge702 in a snap-fit fashion. In at least one embodiment, projection 706can be releasably retained within aperture 704 until a force is appliedthereto by staples deployed from the staple cartridge and/or when theend-effector is opened as described above.

In various embodiments, referring to FIG. 27, staple cartridge 322″and/or anvil 326″, for example, can include notches 334″ which can beconfigured to receive buttress material 336″. In at least oneembodiment, notches 334″ can be configured to releasably retain buttressmaterial 336″ to staple cartridge 322″. In at least one such embodiment,buttress material 336″ can be press-fit between retaining members 302″and 304″ such that a force must be applied thereto to overcome frictionbetween buttress material 336″ and retaining members 302″ and 304″. Invarious embodiments, retaining members 302″ and 304″ can include lips oroverhangs which can prevent, or at least inhibit, buttress material 336″from lifting upwardly. In various embodiments, referring to FIG. 28, anend-effector assembly can include staple cartridge 422 and anvil 426,wherein at least one of the staple cartridge and the anvil can includefirst retaining member 402 and/or second retaining member 404 extendingtherefrom. In at least one embodiment, the first and second retainingmembers 402 and 404 can extend substantially perpendicular to and/ortransverse with respect to one of deck 428 and/or face 432 to retain apiece of buttress material 436 to the end effector. In variousembodiments, first and second retaining members 402 and 404 can beconfigured to releasably retain buttress material 436 therebetween in afriction-fit fashion. In at least one embodiment, the coefficient offriction between the side walls and the retaining members can besufficient such that the buttress material may not be dislodged as theend effector is inserted into and manipulated within a surgical site.After the staples have been deployed into the soft tissue, theend-effector can be re-opened and, in various embodiments, the frictionforce between buttress material 436 and retention members 402 and 404can be overcome.

In various embodiments, referring to FIG. 32, an end-effector of asurgical stapling instrument can include an anvil and a staple cartridge(not illustrated), wherein, as outlined above, the anvil can beoperatively engaged with the staple cartridge such that the end-effectorcan be configured to clamp tissue therebetween. In at least oneembodiment, anvil 626 can include face 632 and, in addition, slot 602which can be configured to slidably receive a cutting member, such ascutting member 668, for example, therein. In various embodiments,although not illustrated, the staple cartridge can also include a slotconfigured to slidably receive cutting member 668 therein. In any event,cutting member 668 can include a blade, such as blade 670, for example,where blade 670 can be configured to incise soft tissue and/or buttressmaterial 636 positioned within the end effector.

In at least one embodiment, referring again to FIG. 32, buttressmaterial 636 can include a body portion having a surface, such assurface 604, for example, wherein the surface can be configured to bepositioned adjacent to anvil face 632, for example. In variousembodiments, buttress material 636 can further comprise projection 606extending from the body portion in a perpendicular and/or transversedirection with respect to surface 604. In at least one embodiment,projection 606 can be configured to be inserted into and engaged withcutting member slot 602 to releasably retain buttress material 636 toanvil 626. Although not illustrated, a piece of buttress material caninclude similar features which can retain the buttress material to astaple cartridge.

In various embodiments, cutting member slot 602 can include first sidewall 608 and second side wall 610 wherein projection 606 can beconfigured to be frictionally engaged with, and/or press-fit between,the first and second side walls and releasably retain projection 606within slot 602. In at least one embodiment, slot 602 can includetransverse portion 612 which can be configured to receive cam members631 extending from cutting member 668, wherein cam members 631 can beconfigured to hold anvil 626 in a closed position. In at least oneembodiment, projection 606 can include at least one tab 614 extendingtherefrom which can be configured to at least partially extend intotransverse portion 612 and assist in retaining projection 606 withinslot 602. In various embodiments, a projection can include resilientfeatures which can apply a biasing force to the side walls of slot 602when they are compressibly received within slot 602.

In various embodiments, further to the above, cutting member 668 can beconfigured to incise projection 606 as it is advanced within anvil 626and separate first portion 618 from second portion 620. In at least oneembodiment, grooves 616 can reduce the cross-sectional thickness ofbuttress material 636 in order to reduce the force needed to transectthe buttress material. In various embodiments, one or more of grooves616 can be sized and dimensioned such that at least a portion ofprojection 606 is thinner than first portion 618 and/or second portion620. As described above, at least one of grooves 616 can be V-shaped,for example, such that cutting edge 670 can contact projection 606 at ornear the point of the V-shaped profile. In various embodiments, althoughnot illustrated, projection 606, for example, can include at least oneperforation defined therein which can lower the force needed to incisethe projection.

In various embodiments, either in addition to or in lieu of the buttressmaterial attachment devices discussed above, a piece of buttressmaterial can be attached to an end-effector of a surgical instrumentusing an adhesive. In at least one embodiment, referring to FIGS. 29 and30, end-effector assembly 514 can include anvil 526 having face 532 and,in addition, staple cartridge channel 522 having deck surface 528. In atleast one embodiment, a piece of buttress material, such as buttressmaterial 536, for example, can be positioned adjacent to one of face 532and deck surface 528, wherein buttress material 536 can include bodyportion 502 and at least one handle portion 506. In at least one suchembodiment, handle portion 506 can extend from body 502 such that asurgeon can use handle portion 506 to position and align buttressmaterial 536 within the end-effector assembly. In at least oneembodiment, handle portion 506 can extend in a direction which isparallel to, and/or transverse to, a plane of surface 504.

In various embodiments, referring to FIGS. 29 and 30, a piece ofbuttress material can include an un-activated or inert adhesive, such asadhesive 512, for example, on the surface of the buttress material whichcan be applied to the surface prior to the surface being positionedagainst one of the staple cartridge deck and the anvil face. In at leastone embodiment, adhesive 512 can be configured to releasably bondsurface 504, for example, to face 532 and/or deck 528 when the adhesiveis activated by a reactant. Similar to the above, such an activatedadhesive can be used to releasably retain surface 504 in contact withface 532 and/or deck 528. In various embodiments, the activated adhesivecan be configured to release the buttress material from the deck and/orface in response to a force applied thereto such as when the staples aredeployed from the staple cartridge and/or when the end-effector isopened, for example. In various embodiments, the un-activated adhesivecan be applied to the buttress material along the outer perimeter ofbody portion 502 such that a reactant, for example, can be easilyapplied to the un-activated adhesive.

In various embodiments, the un-activated adhesive on the buttressmaterial can comprise one component of a binary adhesive and thereactant can comprise the other component of the binary adhesive suchthat, when the two components are combined, the adhesive is activated.Stated another way, the un-activated adhesive can include a materialwhich is inert until it is introduced to a reactant as described below.In at least one embodiment, the un-activated adhesive and the reactantcan comprise a surgically suitable epoxy, for example. In variousembodiments, the un-activated adhesive can include a hydro-stablematerial, for example, such that the adhesive can be substantiallynon-soluble and/or substantially non-reactive when introduced to water.In at least one embodiment, the adhesive can include a material such asa hot melt adhesive, silicone, urethane, cyanoacrylate, hydrogel, and/orisocyanolate, for example, or any suitable monomer and/or polymer. Invarious embodiments, suitable adhesives and attachment devices caninclude those disclosed in U.S. Pat. No. 5,263,629, entitled METHOD ANDAPPARATUS FOR ACHIEVING HEMOSTASIS ALONG A STAPLE LINE, which issued onNov. 23, 1993; U.S. Pat. No. 6,656,193, entitled DEVICE FOR ATTACHMENTOF BUTTRESS MATERIAL TO A SURGICAL FASTENING DEVICE, which issued onDec. 2, 2003; U.S. Pat. No. 6,592,597, entitled ADHESIVE FOR ATTACHINGBUTTRESS MATERIAL TO A SURGICAL FASTENING DEVICE, which issued on Jul.15, 2003; U.S. Pat. No. 6,273,897, entitled SURGICAL BETTRESS ANDSURGICAL STAPLING APPARATUS, which issued on Aug. 14, 2001; and U.S.patent application Ser. No. 10/674,303, entitled APPARATUS AND METHODFOR ATTACHING A SURGICAL BUTTRESS TO A STAPLING APPARATUS, which wasfiled on Sep. 30, 2003, now U.S. Patent Application Publication No.2005/0070929, the entire disclosures of which are hereby incorporated byreference herein. In various embodiments, the reactant can include amaterial comprising at least one aerobic initiator, anaerobic initiator,quaternary ammonium salt or compound, and/or any other suitable radicalmechanism initiator such as anionic initiators, for example, includingthe materials disclosed in U.S. patent application Ser. No. 11/479,424,entitled ABSORBABLE CYANOACRYLATE COMPOSITIONS, which was filed on Jun.30, 2006, now U.S. Patent Application Publication No. 2008/0003196, theentire disclosure of which is hereby incorporated by reference herein.In various embodiments, adhesives and/or reactants which arecommercially available from Closure Medical Corporation, for example,can be used. In at least one embodiment, an adhesive can be configuredto be activated by ultra-violet light or any suitable photochemicalprocess. Several such adhesives are commercially available from HenkelLoctite Corporation, for example.

Further to the above, in various embodiments, the use of theun-activated or inert adhesive on the piece of buttress material canenable a surgeon to position and re-position the piece of buttressmaterial on the anvil face and/or the staple cartridge deck without theadhesive immediately bonding thereto. In at least one embodiment, theun-activated adhesive may not bond to the face and/or deck until thereactant is applied to the un-activated adhesive. This feature providesa significant advantage in that the surgeon does not have to properlyposition the piece of buttress material on a first attempt, but insteadcan position and re-position the piece of buttress material on the deckand/or face to ensure a proper fit and alignment with the face and/orthe deck. In various embodiments, at least one retention or alignmentmember, such as retention member 318 (FIG. 23), for example, can be usedin conjunction with the adhesive/reactant to retain the piece ofbuttress material to the face and/or deck of the end-effector prior toapplication of the reactant, for example.

In various embodiments, a piece of buttress material can include atleast one groove or channel which can be configured to receive thereactant. In at least one embodiment, referring to FIG. 29, buttressmaterial 536 can include recesses 508 which can be located intermediatebody portion 502 and handle portions 506. More particularly, a firstrecess 508 can be provided intermediate a first side of body 502 and afirst handle portion 506 and, additionally, a second recess 508 can beprovided intermediate a second side of body 502 and a second handleportion 506. In various embodiments, at least a portion of un-activatedadhesive 512 on buttress material 536 can extend along recesses 508 suchthat an applicator, such as applicator 514, for example, can be insertedinto recesses 508 to apply the reactant to adhesive 512 and activate theadhesive. In at least one embodiment, as a result, recesses 508 canfacilitate the application of the reactant. In various embodiments,reactant applicator 514 can include absorbent tip 516 which can beconfigured to releasably store and apply a quantity of reactant.

In various embodiments, referring to FIGS. 30 and 31, at least oneperforation can be defined within a piece of buttress material 536 toallow at least one of handle portions 506 to be detached from bodyportion 502, for example. In at least one embodiment, perforations 510can be located intermediate body portion 502 and handle portions 506such that, when a sufficient force is applied to a handle portion 506,the piece of buttress material can tear along a line, or path, definedby perforations 510. In various embodiments, perforations 510 can bepositioned adjacent to and/or within recesses 508 such that handleportion 506 can easily be separated from body 502 owing to the reducedmaterial thickness of the buttress material within and/or adjacent torecesses 508. In at least one embodiment, as a result of the above, apiece of buttress material can be positioned within an end-effector, areactant can be applied to un-activated adhesive on the buttressmaterial, and at least one of the handle portions can be removed from acentral body portion of the buttress material.

In various embodiments, a piece of buttress material, an un-activatedadhesive, and a reactant can be included in a surgical accessory kit,for example. In at least one embodiment, the un-activated adhesive canbe pre-applied to the buttress material. In other embodiments, a surgeoncan use the kit to apply the un-activated adhesive to a surface of thebuttress material and allow the adhesive to “set”, i.e., cure or drysuch that it can be positioned on a surface without substantiallyadhering to the surface. In at least one embodiment, the piece ofbuttress material can then be positioned against one of the staplecartridge or anvil of an end-effector. In at least one such embodiment,as outlined above, the buttress material can include at least one handleextending therefrom in which the surgeon can grasp to manipulate thebuttress material relative to the end-effector. Thereafter, the anvil ofthe end-effector can be closed onto the buttress material to hold it inposition until the reactant is applied thereto. At such point, referringto FIG. 31, the handle portion can be removed while the anvil is closed.Alternatively, the surgeon can wait for the activated adhesive to atleast partially cure before removing the handle. In either event, theend-effector can then inserted into a surgical site and the buttressmaterial can be attached to tissue with staples as described above. Inother various embodiments, the handle portion(s) can be torn away fromthe body portion of the buttress material after staples are engaged withthe tissue.

In various embodiments, a package assembly for at least one piece ofbuttress material can include means for activating an un-activatedadhesive on the buttress material. In at least one embodiment, a packageassembly can include a quantity of reactant stored therein wherein thereactant can be released such that it can come into contact with theun-activated adhesive and activate the adhesive. In other variousembodiments, a package assembly can include an initiator which can beconfigured to cause a reaction between an un-activated adhesive andanother chemical within the package assembly. In further variousembodiments, an un-activated adhesive can be configured to activate whensufficient pressure is applied thereto. Such pressure can be generatedwhen the anvil of the end effector is closed onto the buttress materialand clamped against the staple cartridge. Such materials can compriseone or more pressure-sensitive adhesives such as silicone adhesives andacrylic adhesives, for example. In various embodiments, a package caninclude a piece of buttress material having a biocompatible hot-meltadhesive positioned thereon, wherein the adhesive can be configured tomelt when heat, generated by an exothermic chemical reaction, is appliedthereto. In at least one embodiment, an initiator can be mixed with achemical to create the exothermic reaction and thereby generate heat inthe localized region of the adhesive, for example. In variousembodiments, the initiator can be separated from the chemical by aremovable sheet or other suitable separation device such that, when thesheet is removed, the initiator and the chemical can be exposed to eachother. In at least one such embodiment, the initiator can include anoxidizer, or any suitable chemical compound that readily transfersoxygen atoms, for example, and the chemical can include can include ironor an iron compound, for example, which can be oxidized by the oxidizerto create an exothermic reaction.

In various embodiments, a package can include a piece of buttressmaterial having a biocompatible hot-melt adhesive thereon, wherein theadhesive can be configured to be melted when heat generated by anelectrical power source, such as a battery, for example, is appliedthereto. In at least one embodiment, the package can include theelectrical power source. In further various embodiments, the energysource can be provided on a portion of an end-effector, a piece ofbuttress material, a sleeve for an end-effector, and/or a buttressmaterial applicator, for example. In various embodiments, the packageassembly can include first and second contacts, and/or any othersuitable conductors and resistors, which can be configured to operablycomplete an electrical circuit with the battery. In at least oneembodiment, the electrical power source can be activated by a switch onthe package, for example, and the electrical energy can be applied tothe contacts.

In various embodiments, the anvil of an end-effector assembly caninclude a detachable portion or sleeve which can be configured to beslid over a second portion of the anvil and attached to the end-effectorassembly. In at least one embodiment, as described in greater detailbelow, a piece of buttress material can be attached to the sleeve beforethe sleeve is assembled to the end-effector assembly. In at least oneembodiment, referring to FIG. 34, sleeve 802 can be configured to beslid over anvil portion 826 such that sleeve 802 is held in place by atleast one of a snap-fit and press-fit configuration. In at least onesuch embodiment, sleeve 802 can be configured to at least partiallysurround an outer perimeter 804 of anvil portion 826 wherein sleeve 802can be configured to engage outer perimeter 804. In various embodiments,sleeve 802 can include anvil pockets 806 defined in working surface 808wherein pockets 806 can be configured to deform staples deployed from astaple cartridge as described above. In various embodiments, sleeve 802can be cast or machined from a piece of metal into any suitableconfiguration and can be comprised of any suitable material such asaluminum, for example.

As indicated above and referring to FIG. 34, sleeve 802 can includebuttress material 836 thereon, wherein at least a portion buttressmaterial 836 can be releasably attached to sleeve 802 using an adhesive,for example. In at least one embodiment, referring to FIG. 35, buttressmaterial 836′ can include body portion 812′ and at least one sideportion 814′, wherein side portions 814′ can be releasably attached tosleeve 802′ with an adhesive 810′. In various embodiments, side portions814′ can be detached from sleeve 802′ when a force is applied thereto.In at least one embodiment, similar to the above, such a force can becreated when staples are deployed from the staple cartridge and engagedwith the buttress material. In various embodiments, referring to FIG.36, a piece of buttress material can further include at least oneperforation and/or recess which can allow a tissue-contacting portion ofthe buttress material to be separated from a portion of the buttressmaterial which is adhered to the end-effector. In at least oneembodiment, buttress material 836″ can include body portion 812″ whichcan be configured to contact tissue positioned within the end-effectorand, in addition, side portions 814″ which can be adhered to anvilsleeve 802″, for example, by adhesive 810″. In various embodiments,buttress material 836″ can further include one ore more perforations816″ defined therein which can be located intermediate body portion 812″and side portions 814″. In addition to or in lieu of side portions 814″separating from sleeve 802″ as outlined above, body portion 812″ can beconfigured to detach from side portions 814″ along a path defined byperforations 816″ when a force is applied thereto. In at least one suchembodiment, side portions 814″ can remain attached to sleeve 802″ afterbody portion 812″ has been separated therefrom. In other variousembodiments, referring to FIG. 37, sleeve 802′″ can include a piece ofbuttress material, such as buttress material 836′″, for example, caninclude one or more recesses 818′″ positioned intermediate body portion812′″ and side portions 814′″ which can, similar to the above, allowbody portion 812′″ to separate from side portions 814′″.

Further to the above, in various embodiments, once the body portion hasbeen released from the side portions, the end-effector can be moved awayfrom the tissue and the buttress material stapled to the tissue. In atleast one embodiment, the spent sleeve 802, for example, can then beslid off of anvil portion 826, discarded, and replaced with anothersleeve. In at least one such embodiment, the replacement sleeve caninclude a piece of buttress material, such as buttress material 836, forexample, positioned thereon such that the end-effector can be re-used.In various embodiments, the discarded sleeve can be sterilized, asdescribed below, and another piece of buttress material can be attachedto the sleeve such that it can be used once again.

In various embodiments, a package including a piece of buttress materialcan be configured to apply the piece of buttress material to one of ananvil and a staple cartridge of an end-effector. In at least oneembodiment, referring to FIGS. 38-40, package 902 can include firstportion 904 having surface 905 which can be configured to releasablyretain piece of buttress material 936 thereto. In various embodiments,surface 908 of buttress material 936 can include adhesive 910, whereinadhesive 910 can be configured to releasably attach buttress material936 to anvil 926. In addition to first portion 904, package 902 caninclude second portion 906 attached to first portion 904 where secondportion 906 can have a second piece of buttress material, such asbuttress material 937, for example, attached thereto. In variousembodiments, similar to buttress material 936, buttress material 937 caninclude adhesive thereon which can be utilized to releasably attachbuttress material 937 to staple cartridge 922. In order to removeportions 904 and 906 from the pieces of buttress material, at least oneof portions 904 and 906 can be grasped by the surgeon and pulled awayfrom the pieces of buttress material as illustrated in FIG. 40. Ineffect, package 902 can be moved between a first, attached position anda second, detached position.

In various embodiments, referring to FIGS. 41-46, a package assembly forat least one piece of buttress material can include an outer package901′ which can be configured to enclose an inner package 902′ in asterile environment. In use, a surgeon can open outer package 901′,remove inner package 902′, and manipulate inner package 902′ to exposebuttress material 936′. In at least one embodiment, inner package 902′can include a cover sheet comprising first portion 904′ and secondportion 906′, wherein the first and second portions can be configured toat least partially enclose buttress material 936′ when they are in afirst position as illustrated in FIG. 42. In various embodiments, asurgeon can rotate second portion 906′ relative to first portion 904′ bygrasping and pulling tab 938′ positioned on second end 940′ of secondportion 906′, as illustrated in FIG. 42, and moving second portion 906′into a second position as sequentially illustrated in FIGS. 43 and 44.In at least one such embodiment, the surgeon can rotate second portion906′ relative to first portion 904′ until second portion 906′ is atleast partially positioned adjacent to first portion 904′.

Thereafter, in various embodiments, buttress material 936′ can then bealigned with one of an anvil and/or staple cartridge of an end-effectoras described above. In at least one embodiment, referring to FIGS. 45and 46, inner package 902′ can be inserted within end-effector 914′intermediate anvil 926′ and staple cartridge 922′ such that buttressmaterial 936′ can be aligned with staple cartridge 922′, for example. Invarious embodiments, similar to the above, anvil 926′ can be rotatedtoward staple cartridge 922′ and clamped onto package 902′ and buttressmaterial 936′ such that buttress material 936′ can be pressed againststaple cartridge 922′ and adhesive 910 can secure buttress material 936′thereto. Thereafter, anvil 926′ can be reopened and sheet 918′ can bepeeled, or otherwise removed, from buttress material 936′.

In various alternative embodiments, a package assembly can include oneor more draw strings configured to detach a cover sheet from a buttressmaterial contained within the package assembly. In at least one suchembodiment, the cover sheet can be manipulated to expose the buttressmaterial, the buttress material can be secured to an end effector, andthe draw strings can be pulled proximally, or distally, to detach thecover sheet from the buttress material. In various other embodiments,referring to FIGS. 47 and 48, draw strings can be attached to a portionof the buttress material such that a handle portion, for example, of thebuttress material can be removed from a tissue-contacting portion of thebuttress material. In at least one such embodiment, buttress material1002 can be clamped between an anvil and a staple cartridge of an endeffector, and a force can be applied to draw strings 1006 which areattached to handle portion 1004 of buttress material 1002. In variousembodiments, as a result, distal end 1003 of buttress material 1002 canbe pulled toward proximal end 1005 by draw strings 1006 such that handleportion 1004 can detach from tissue-contacting portion 1036 alongperforations 1008. In at least one embodiment, buttress material 1002can further include aperture 1010 which can be located at the distal endof tissue-contacting portion 1036, wherein aperture 1010 can define apre-detached point between handle portion 1004 and tissue-contactingportion 1036 in order to reduce the force required to detach handleportion 1004. In at least one embodiment, referring to FIG. 49, at leastone draw string 1006′ can be attached to handle portion 1004′ ofbuttress material 1002′ such that proximal end 1005 can be pulled towarddistal end 1003 to remove handle portion 1004.

In various embodiments, an applicator can be used to apply a piece ofbuttress material to at least one of an anvil and a staple cartridge ofan end-effector. In at least one embodiment, referring to FIGS. 50-53,applicator assembly 1102 can comprise applicator 1104 and at least onepiece of buttress material 1136, wherein applicator 1104 can include atleast one surface for supporting buttress material 1136 thereon. In atleast one such embodiment, applicator 1104 can include top surface 1106and bottom surface 1108 wherein each of the top and bottom surfaces canbe configured to releasably receive at least one piece of buttressmaterial 1136. In various embodiments, each piece of buttress material1136 can be releasably attached to the top and bottom surfaces ofapplicator 1104 through the use of an adhesive and/or mechanicalattachment member, for example. Referring to FIGS. 50 and 51, each pieceof buttress material 1136 can include a face 1110 which can be at leastpartially coated with an adhesive to retain face 1110 to theend-effector. In at least one such embodiment, the adhesive can beapplied to buttress material 1136 at a plurality of locations 1112.

In order to apply a piece of buttress material to a staple cartridgeand/or anvil of an end-effector assembly using an applicator such asapplicator 1104, for example, the applicator can be at least partiallypositioned intermediate the staple cartridge and the anvil such that theanvil can be closed onto the buttress material. In various embodiments,referring to FIGS. 52 and 53, applicator assembly 1102 can be at leastpartially positioned intermediate anvil 1126 and staple cartridge 1122of end-effector 1114 such that anvil 1126 can be aligned with and closedonto buttress material 1136. In at least one embodiment, applicator 1104can further include alignment slot 1116 at a first end and tongueportion 1117 at a second end, wherein a surgeon can use alignment slot1116 to align and position applicator assembly 1102 within end-effector1114. In at least one such embodiment, alignment slot 1116 can beconfigured such that end-effector 1114 is closely received between thesidewalls of alignment slot 1116. Owing to adhesive 1112, the pieces ofbuttress material 1136 can be adhered to anvil 1126 and staple cartridge1122 such that when anvil 1126 is reopened, applicator 1104 can beremoved from end-effector assembly 1114, leaving behind the pieces ofbuttress material within the end-effector.

In various embodiments, at least one protective sheet (not illustrated),similar to sheet 918, for example, can be positioned over face 1110 suchthat applicator 1104 can be positioned and repositioned on one of theanvil and the staple cartridge of end-effector 1114 without adhesive1112, for example, bonding to the anvil and/or the staple cartridge. Inat least one such embodiment, the sheets can be removed by the surgeononce the applicator is properly positioned and aligned within theend-effector to allow the adhesive to contact the staple cartridgeand/or anvil of the end-effector. In various embodiments, in addition toor in lieu of tongue 1117, an applicator can include at least one grip,such as grips 1134, for example, which can be configured to allow asurgeon to more easily manipulate the applicator within an end-effector.In at least one embodiment, a first grip 1134 can be provided on a firstside of applicator 1104, and, in addition, a second grip 1134 can beprovided on a second side of the applicator. In various embodiments, agrip can include ridges 1138 which can be configured to allow thesurgeon to more easily handle applicator 1104. To this end, at least aportion of grips 1134 can be comprised of a soft or elastic materialsuch as rubber, for example.

In other various embodiments, although not illustrated, the packagingfor at least one piece of buttress material can comprise a tubularsleeve which can be configured to be positioned around at least one ofan anvil and a staple cartridge. In at least one embodiment, thebuttress material can include an adhesive thereon which can beconfigured to releasably attach the piece of buttress material to atleast one of the anvil and the staple cartridge. In at least one suchembodiment, the tubular sleeve can be configured to receive at least oneof the anvil and the staple cartridge therein such that the anvil and/orstaple cartridge are aligned with a piece of buttress material withinthe tubular sleeve. In various embodiments, a tubular sleeve can includea middle wall extending between a first side and a second side of aninner perimeter of the sleeve. In various embodiments, the middle wallcan include a top surface and a bottom surface, wherein the top andbottom surfaces can each be configured to releasably retain a piece ofbuttress material thereto. In at least one such embodiment, theend-effector can be aligned relative to the middle wall and can beclosed onto the middle wall to attach the buttress material to the anviland/or staple cartridge.

In various embodiments, a buttress material dispenser can be utilized todispense buttress material. In at least one embodiment, referring toFIGS. 54 and 55, dispenser 1200 can be configured to dispense buttressmaterial 1236 from a housing assembly comprised of housing portions 1210and 1212. As described in greater detail below, dispenser 1200 caninclude a roll, or spool, 1224 of buttress material wherein the buttressmaterial can be dispensed from spool 1224 onto an end effector of asurgical instrument as illustrated in FIG. 57. In various embodiments,buttress material 1236 can be adhered to, or otherwise supported by,carrier strip 1202 such that, as buttress material 1236 is dispensed,buttress material 1236 can be separated from carrier strip 1202. Invarious embodiments, referring to FIGS. 54-57, carrier strip 1202 caninclude surface 1204 which can be configured to receive buttressmaterial 1236 thereon. In various embodiments, buttress material 1236can be divided into pieces before and/or after it is placed onto surface1204. In at least one embodiment, the pieces of buttress material 1236can each have a width which is the same as or less than the width ofsurface 1204 and, in various embodiments, the pieces of buttressmaterial can be releasably attached to surface 1204 of carrier 1202using a low-strength adhesive, for example.

In various embodiments, referring to FIGS. 54-57, internal wall 1214 offirst housing portion 1210 can include a plurality of connectors 1216extending therefrom. In at least one embodiment, connectors 1216 can beengaged with other connectors extending from, or apertures within, aninternal wall of second portion 1212 in order to secure the first andsecond housing portions together. In various embodiments, referring toFIG. 56, dispenser 1200 can further include spool pin 1242 which can beconfigured to rotatably support spool 1224. In at least one suchembodiment, spool pin 1242 can be engaged with aperture 1241 in housingportion 1210 and an aperture (not illustrated) in second portion 1212.In various embodiments, spool pin 1242 can be mounted to spool 1242 suchthat they can be rotated together. As outlined above, buttress material1236 and carrier strip 1202 can be unspooled from spool 1224 as buttressmaterial 1236 is dispensed. In at least one embodiment, a force can beapplied to buttress material 1236 such that it can be manually pulledout of dispenser 1200. In other various embodiments, as described ingreater detail below, buttress dispenser 1200 can further include thumbroller 1234 which can be sufficiently engaged with buttress material1236 such that a surgeon, or other clinician, can rotate thumb roller1234 and push buttress material 1236 out of dispenser 1200. In at leastone embodiment, referring to FIG. 55, dispenser 1200 can further includethumb roller pin 1235 which can be configured to rotatably support thumbroller 1234 within the dispenser housing. In at least one embodiment,thumb roller 1234 can be mounted to pin 1235 such that they can berotated together about an axis defined by aperture 1249 in first housingportion 1210 and an aperture (not illustrated) in second housing portion1212.

In various embodiments, referring to FIG. 55, thumb roller 1234 can beconfigured to extend at least partially through aperture 1239 in thedispenser housing such that thumb roller 1234 can be rotated by thesurgeon. In at least one embodiment, thumb roller 1234 can be configuredto operatively contact, or frictionally engage, buttress material 1236and/or carrier 1202 such that the rotation of thumb roller 1234 candrive or motivate buttress material 1236 distally toward drive roller1232. In addition to or in lieu of the above, drive roller 1232 can beconfigured to operatively contact, or frictionally engage, buttressmaterial 1236 and/or carrier 1202. In at least one embodiment, driveroller 1232 can be operably engaged with thumb roller 1234 via drivebelt 1243, for example, such that the rotation of thumb roller 1234 canbe transmitted to drive roller 1232. Although a drive belt isillustrated, any other suitable device, such as a drive chain or band,for example, can be used. In various embodiments, at least one ofhousing portions 1210 and 1212 can include guides 1262 which can beconfigured to align drive belt 1243 with thumb roller 1234 and driveroller 1232.

As described above, carrier strip 1202 can be separated from buttressmaterial 1236 as buttress material 1236 is dispensed from dispenser1200. In various embodiments, dispenser 1200 can further include carrierstrip collector 1228 which can be configured to wind up carrier strip1202 after it has been detached from buttress material 1236. In at leastone embodiment, carrier strip collector 1238 can be mounted to at leastone of spool 1224 and spool pin 1242 such that spool 1224 and stripcollector 1228 can be rotated in unison. In at least one suchembodiment, carrier strip 1202 can be collected around strip collector1228 in a direction which is opposite to the direction in which buttressmaterial 1234 is dispensed from spool 1224. As a result, buttressmaterial 1234 can be dispensed and carrier strip 1202 can be collectedsimultaneously. In various embodiments, dispenser 1200 can furtherinclude separating plate 1230 which can be utilized to peel, orseparate, buttress material 1234 from carrier 1202. In at least oneembodiment, separating plate 1230 can include edge 1258 about whichcarrier 1202 can be redirected such that carrier 1202 can be pulledproximally by strip collector 1228 as described above.

In various circumstances, slack may be developed within carrier strip1202 after it has been separated from buttress material 1236. In atleast one embodiment, dispenser 1200 can include one ore more tensioningdevices to reduce such slack within carrier strip 1202. In variousembodiments, similar to the above, dispenser 1200 can further includepin 1218 which can be rotatably supported within aperture 1251 in firsthousing portion 1210 and an aperture (not illustrated) in second housingportion 1212 wherein pin 1218 can be configured to rotatably supportpressure roller 1222. In various embodiments, referring particularly toFIGS. 56 and 57, dispenser 1200 can further include second drive roller1253 which can be configured to cooperate with pressure roller 1222. Inat least one embodiment, second drive roller 1253 can be operablyengaged with thumb roller 1236 such that the rotation of thumb roller1234 can be transmitted to drive roller 1253. In various embodiments,dispenser 1200 can further include a gear train comprising spur gear1244 mounted to at least one of thumb roller 1234 and pin 1235,intermediate gear 1246 rotatably supported by pin 1247, and driven gear1252 which can be operably engaged with drive roller 1253. In at leastone such embodiment, carrier strip 1202 can be positioned intermediatedrive roller 1253 and pressure roller 1222 such that, when driver roller1253 is rotated by thumb roller 1234, driver roller 1253 can drivecarrier strip 1202 proximally. In at least one embodiment, pressureroller 1222 and/or driver roller 1253 can be comprised of an at leastpartially compressible material such that pressure roller 1222 can holdcarrier strip 1202 against driver roller 1253.

As described above, referring to FIGS. 54-57, applicator 1200 caninclude housing 1201 comprising first portion 1210 and second portion1212, wherein the first and second portions can be configured to beattached to one another. In at least one embodiment, the first andsecond portions of housing 1201 can be screwed, snapped, and/orotherwise engaged with each other. In various embodiments, the first andsecond housing portions can be releasably engaged with each other suchthat the first and second housing portions can be separated in order toremove and replace an expended spool of buttress material. In at leastone embodiment, the housing can include ergonomic features such that thehousing can be easily gripped by a surgeon.

In other various embodiments, referring to FIGS. 58-61, dispenser, orapplicator, 1266 can include spool 1267 from which buttress material1236 can be dispensed and, in addition, collection spool 1270 which canbe configured to collect carrier strip 1202 after it has been separatedfrom buttress material 1236. Similar to the above, buttress material1236 can be dispensed from applicator 1266 via the engagement betweenbuttress material 1236, thumb roller 1234, and/or drive roller 1232. Inat least one embodiment, collection spool 1270 can also be operativelyengaged with thumb roller 1234 such that the rotation of thumb roller1234 can rotate spool 1270 and collect carrier strip 1202 therearound.In various embodiments, applicator 1266 can include a gear traincomprising spur gear 1244 mounted to at least one of thumb roller 1234and pin 1235, intermediate gear 1246 rotatably supported by pin 1247,and driven gear 1272 which can be mounted to at least one of spool 1270and pin 1271. In at least one such embodiment, as a result, the rotationof thumb roller 1234 can drive collection spool 1270, directly apply aforce to carrier strip 1202, and collect carrier strip 1202 around spool1270.

In various embodiments, referring to FIGS. 57 and 61, buttress materialapplicators 1200 and/or 1266 can be used to apply a piece of buttressmaterial to a deck “D” of a staple cartridge “SC” and/or a face “F” ofan anvil “A”. In at least one embodiment, as illustrated in FIG. 61, asurgeon can first place applicator 1266, for example, against first end1276 of deck D. Thereafter, the surgeon can pull the applicator towardssecond end 1278 of deck D while rotating thumb roller 1234 to dispensebuttress material 1236. As discussed above, buttress material 1236 canbe separated into pieces and, in at least one embodiment, the length ofthe pieces can such that the pieces of buttress material properly fit onthe staple cartridge deck and/or the anvil face. In other variousembodiments, the piece of buttress material can be comprised of onecontinuous strip and the applicator can include a cutting member (notillustrated) which can be configured to cut the buttress material to anysuitable length. In various embodiments, the pieces of buttress materialcan include an adhesive thereon, or which can be applied thereto, whichcan be configured to releasably retain the buttress material to one ofthe deck and/or the face.

In various embodiments, a piece of buttress material can be manufacturedutilizing an injection molding process. In at least one embodiment, aninjection mold (not illustrated) can include one or more mold cavitiesdefined therein which can be configured to receive a molten material,for example. In various embodiments, the molten material can include aplastic and/or any other suitable buttress material. In variousembodiments, the mold can further include at least one sprue cavityand/or runner which can place the mold cavities in fluid communicationwith an injection molding machine. In at least one embodiment, the moldcan include first and second portions which can be separated after themolten material has sufficiently solidified or hardened within the moldcavities.

In various embodiments, referring to FIGS. 62 and 63, piece of buttressmaterial 1336 can include first surface 1302 and second surface 1304,wherein the first and second surfaces can each include plurality ofapertures, or recesses, 1306 formed therein. In at least one embodiment,recesses 1306 can be formed by molten material within a mold during aninjection molding process. More particularly, the mold can include oneor more cavities having a plurality of projections which can beconfigured such that the molten material will flow around theprojections and, when the piece of buttress material 1336 has solidifiedand is removed from the mold, recesses 1306 may be present withinbuttress material 1336 where the projections were previously situated.

In various embodiments, buttress material 1336 can further include aplurality of walls, such as walls 1305, for example, formed intermediatefirst and second surfaces 1302 and 1304 wherein walls 1305 can definerecesses 1306. In at least one embodiment, walls 1305 can beperpendicular and/or transverse to the first and second surfaces suchthat walls 1305 can be structured and arranged to form a pattern or gridof recesses 1306 within buttress material 1336. In various embodiments,buttress material 1336 can be resilient such that first surface 1302and/or second surface 1304 can be compressed towards one another. In atleast one such embodiment, buttress material 1336 can be configured suchthat it can be compressed or press-fit between two or more retentionmembers of an end-effector as described above. In various embodiments, apiece of buttress material can be compressed when applied to anend-effector of a surgical instrument and can then expand when it isreleased from the end-effector. In at least one embodiment, buttressmaterial 1336 can be configured to be compressed such that first surface1310 can be moved toward surface 1312. In any event, walls 1305 can beconfigured such that they can deflect or collapse and allow portions ofbuttress material 1336 to resiliently move toward one another.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicecan be disassembled, and any number of the particular pieces or parts ofthe device can be selectively replaced or removed in any combination.Upon cleaning and/or replacement of particular parts, the device can bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Thoseskilled in the art will appreciate that reconditioning of a device canutilize a variety of techniques for disassembly, cleaning/replacement,and reassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

Preferably, the invention described herein will be processed beforesurgery. First, a new or used instrument is obtained and if necessarycleaned. The instrument can then be sterilized. In one sterilizationtechnique, the instrument is placed in a closed and sealed container,such as a plastic or TYVEK bag. The container and instrument are thenplaced in a field of radiation that can penetrate the container, such asgamma radiation, x-rays, or high-energy electrons. The radiation killsbacteria on the instrument and in the container. The sterilizedinstrument can then be stored in the sterile container. The sealedcontainer keeps the instrument sterile until it is opened in the medicalfacility.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples. Further, this application is intended to cover suchdepartures from the present disclosure as come within known or customarypractice in the art to which this invention pertains.

1-16. (canceled)
 17. A staple cartridge assembly for stapling the tissueof a patient, comprising: a cartridge body comprising a longitudinalslot; a proximal end; a distal end; a deck configured to support thetissue; staple cavities defined in said deck; staples removably storedin said staple cavities; buttress material positioned over said deck; anabsorbable polymer adhesive positioned intermediate said buttressmaterial and said deck configured to releasably hold said buttressmaterial to said deck, wherein said absorbable polymer adhesivecomprises a compliant matrix; and a cutting member configured to movewithin said longitudinal slot and incise said buttress material withoutsubstantially pushing said buttress material distally within said endeffector.
 18. The staple cartridge assembly of claim 17, wherein saidabsorbable polymer comprises urethane.
 19. The staple cartridge assemblyof claim 17, further comprising an attachment portion configured to beattached to a shaft of a surgical stapling instrument.
 20. The staplecartridge assembly of claim 17, further comprising: a proximal retentionmember configured to releasably retain said buttress material to saiddeck; and a distal retention member configured to releasably retain saidbuttress material to said deck.
 21. The staple cartridge assembly ofclaim 17, further comprising an anvil configured to deform said staples.22. A staple cartridge assembly for stapling the tissue of a patient,comprising: a cartridge body comprising a longitudinal slot; a proximalend; a distal end; a deck configured to support the tissue, wherein saiddeck comprises a first step comprising a first step height and a secondstep comprising a second step height which is different than said firststep height; staple cavities defined in said deck comprising a firstlongitudinal row of staple cavities defined in said first step and asecond longitudinal row of staple cavities defined in said second step;staples removably stored in said staple cavities; buttress materialpositioned over said deck; an absorbable polymer adhesive positionedintermediate said buttress material and said deck configured toreleasably hold said buttress material to said first step and saidsecond step, wherein said absorbable polymer adhesive comprises aflexible matrix; and a cutting member configured to move within saidlongitudinal slot and incise said buttress material withoutsubstantially pushing said buttress material distally within said endeffector.
 23. The staple cartridge assembly of claim 21, wherein saidabsorbable polymer comprises urethane.
 24. The staple cartridge assemblyof claim 21, further comprising an attachment portion configured to beattached to a shaft of a surgical stapling instrument.
 25. The staplecartridge assembly of claim 21, further comprising: a proximal retentionmember configured to releasably retain said buttress material to saiddeck; and a distal retention member configured to releasably retain saidbuttress material to said deck.
 26. The staple cartridge assembly ofclaim 21, further comprising an anvil configured to deform said staples.27. A staple cartridge assembly for stapling the tissue of a patient,comprising: a cartridge body comprising a longitudinal slot; a proximalend; a distal end; a deck configured to support the tissue, wherein saiddeck comprises a first step comprising a first step height and a secondstep comprising a second step height which is different than said firststep height; staple cavities defined in said deck comprising a firstlongitudinal row of staple cavities defined in said first step and asecond longitudinal row of staple cavities defined in said second step;staples removably stored in said staple cavities; buttress materialpositioned over said deck; an absorbable polymer adhesive positionedintermediate said buttress material and said deck configured toreleasably hold said buttress material to said first step and saidsecond step, wherein said absorbable polymer adhesive comprises acompliant form; and a cutting member configured to move within saidlongitudinal slot and incise said buttress material withoutsubstantially pushing said buttress material distally within said endeffector.
 28. The staple cartridge assembly of claim 27, wherein saidabsorbable polymer comprises urethane.
 29. The staple cartridge assemblyof claim 27, further comprising an attachment portion configured to beattached to a shaft of a surgical stapling instrument.
 30. The staplecartridge assembly of claim 27, further comprising: a proximal retentionmember configured to releasably retain said buttress material to saiddeck; and a distal retention member configured to releasably retain saidbuttress material to said deck.
 31. The staple cartridge assembly ofclaim 27, further comprising an anvil configured to deform said staples.